Background:The extrarenal Wilms tumor is a rare malignancy in the pediatric population. So far, no extrarenal testicle Wilms tumor followed the operation of left hernia sac high ligation and right cryptorchidism descent fixation has been reported in the literature. Case presentation: We researched an exceptionally unheard case of the extrarenal testicular Wilms tumor after the surgery of left hernia sac high ligation and right cryptorchidism descent fixation in a 2.8 years old boy. The patient was admitted to a hospital due to the evidence of huge scrotum mass six months after the operation of left hernia sac high ligation and right cryptorchidism descent fixation. A huge tumor ascending from the right testicular was found. Conclusions: Histology examination revealed the typical triphasic Wilms tumor elements such as epithelial, mesenchymal, and blastemal areas. This study revealed histopathological, clinical, diagnostic, prognostic, and therapeutic characteristics of this infrequent tumor.